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Tuesday, September 29, 2015

Encountering the Other: Old People

Last November, I joined two other presenters at a professional development seminar for therapists, including social workers, titled, “Aging: Much Wisdom, Much Grief.”  The focus was on the aging process, for both clinicians and their clients.

And though I am neither, I was pleased to be invited as someone who writes about, and offers workshops on, aging.  And, of course, there’s the personal angle: I am myself old.

One of my co-presenters, a clinician and professor, gave what I thought were some interesting, maybe even startling, stats:  only 4% of social work students study gerontology, while 70% will end up working with older clients.

I thought of this disconnect while reading an Op-Ed piece in the September 22 issue of the New York Times: “An Aging Population, Without the Doctors to Match.”

Here’s the sentence that caught my attention:

Most health care professionals have had little to no training in the care of older adults. Currently, 97 percent of all medical students in the United States do not take a single course in geriatrics.

And, further on:

Currently there are fewer than 8,000 geriatricians in practice nationwide — and that number is shrinking. “We are an endangered species,” said Dr. Rosanne Leipzig, a geriatrician at Mt. Sinai Medical Center in New York.

At the same time, the nation’s fastest-growing age group is over 65. Government projections hold that in 2050 there will be 90 million Americans 65 and older, and 19 million people over age 85. The American Geriatrics Society argues that, ideally, the United States should have one geriatrician for every 700 people 65 and older. But with the looming shortage of geriatricians, the society projects that by 2030 there will be only one geriatrician for every 4,484 people 75 and older. [emphasis mine]

Now while I’ve a few years to go before I hit 75, in 15 years I’ll have just entered the Land of the Old-Old: those over 85. (According to the World Health Organization, here’s how the generic “old” currently breaks down: “Young-Old, 65-74”; “Old, 75-84”; and the aforementioned “Old-Old, 85+.”)

I’m not one to seek medical care on any regular basis; I don’t show up in a doctor’s office until some mysterious pain or weird symptom just won't go away. But when I’m well into my 80’s that might change. 

So this particular supply/demand conundrum is of more than passing interest.

The author of the NYT piece, Marcy Cottrell Houle, offers one possible, but compelling, answer: geriatric medicine is low-paying, “even though it requires years of intensive specialization.”  We also know that medical training involves boatloads of student debt. 

A definite bad match.

I couldn’t help wonder, though, if there was more to it than that, one not hinted at in her article: exactly how rewarding might it be for physicians to work with patients at the tail end of their lives?  What might we, as patients, offer our care providers other than advancing decrepitude and certain dying?

I mean, how much fun could it be to work with old people?

Fortunately, the day after the New York Times article, a NPR segment appeared, the title of which—“To Sell Medical Students on Joys of Geriatrics, Send in 90-Year-Olds”—gave me some hope that help was on the way.  And it was, in the form of six of the Old-Old who showed up to share their stories—some touching, some funny, all informative—to close to 200 medical students at Case Western Reserve School of Medicine in Cleveland.

And at the end of their shared time together, one of those students, Jeremy Hill, said:

"I have such respect and admiration for this population, and if I could somehow give them one extra good day they would not have had otherwise," said Hill, who then paused for a moment, "I would be privileged to work with them."

It's a beginning.


For more on both pieces:

Monday, September 21, 2015

Flannery's Story

Not long after my niece and her family moved from Oak Park to Pasadena, I began corresponding by email with her daughter, my great-niece, Natalie.  It was in January 2003 and Natty (as I mostly called her) was seven and a half years old.

Here’s the very first email she sent me:

“HI!!!!! I’m so glad you e-mailed me.  I will always e-mail you withing three days adlest. Lucy came over today it was so fun. OK so about school it is so nice there is a secret gardin. big change is that wehn we paint we stand up. We also don’t right in cursive. And we nit. OK Caril we gota start the family game night. By. Love Natalie”

And so it went for several years, this chatty virtual conversation between us, though Natalie’s spelling became less phonetic and her details more specific over time. I have all of these e-exchanges and will some day give them to her, hoping it will give her a window into her middle-school years especially, the names, places, and experiences from that time in her life that she may not have stored in her own memory.

So this is one way for us adults to “write” our family stories: as letters and emails between us and our kids and grands.  Another is to keep a journal about them, especially of their special growing up moments.  Once written, these letters, emails, and journals can be handed over to the kids when they are older and can more fully appreciate them.

But yet another kind of family story is when we, as kids, keep our own diaries, write our own stories, and exchange our own letters and emails, then hold onto them to re-read as we grow into our 20's, 30's, 40's, and beyond. 

It was this latter form of family story that I was reminded of this past week.

On Sunday last, I conducted a writing workshop at a local Arts Center.  One of the women present had brought her two daughters along, including the youngest, 8-year old Flannery.  The kids weren’t there to participate so much as hang out with their mom until the workshop was over.

But, as I would learn later, young Flannery did participate, doing the exercise that I directed the group to do:  First, to make a list of experiences from any part of their lives that they wanted a full record of--any specific people, places, and events, no matter how big or small, major or minor.

Once everyone had made their list, I told them to then pick any one experience and describe the who, what, where, and when of it, paying particular attention to the who by describing that person in more detail.

Now, in my writing workshops, people never read directly from the writing exercises; an exercise is just that, an exercise, a beginning of some memory that we scratch down, often randomly, on the page.  It’s not yet ready to be shared—if ever—with anyone else. 

But I do ask people to volunteer anything interesting or unusual or meaningful that resulted from the writing exercise.  On that Sunday, as usual, a couple of people in the group did so.

During all this writing and talking, I noticed Flannery and her sister sitting quietly in the back of the room, and it did seem that Flannery was writing something, though at the time I couldn’t guess what. 

Later, with the workshop over and before I left the Center, her mom confirmed that Flannery had indeed joined us in the writing exercise, and so I wrote her mother the next day and asked if I could see what she’d written.

Here’s what her mom responded (after getting Flannery’s permission):

“Flannery LOVED the writing workshop and is happy to have me share her list. I have attached it, and have indicated in parenthesis a few descriptors.”

Now, before I share Flannery’s exercise—with both her and her mother’s permission, of course—here’s why I’m doing so, in this blog dedicated to the over 50 crowd: to encourage readers to encourage their kids and grands to keep a journal, starting at around Flannery's age, even earlier if they are ready.

Because I cannot imagine what immense pleasure 50-year-old Flannery will derive from hearing from her 8-year-old self, this person she both is and is not 42 years on. Just picture her reading it. And so for those readers who would choose to do the encouraging with their kids, I suggest using Flannery’s list and story as an example of how to begin.

So here it is:

First, Flannery’s list, with important details in ( ) provided by her mom:

Going to Disneyworld with Mom
When Duffy (our old dog) and I rolled in the snow
When Dorothy (our next door neighbor’s baby) was born
Gamps taking out his teeth
When I saw Wreck-it-Ralph with Kevin (her adult cousin)
When Connor (brother) found Dangle (our dog he rescued, literally!)
Fred (a geriatric client of mine that Flannery used to visit) and his army and cop stories
My first cartwheel
How DooDah (her friend’s grandpa) would fall asleep in the middle of his stories

And now Flannery’s story:
The Devanes and I would sit on the carpet while DooDah would sit in a big chair. He would start his army stories. By the middle he would be fast asleep. He’d be snoring loud and dreaming about the Japanese war. We would yell, “Go! Go! The Japanese are going to get you, so keep running!” And when we had enough we would yell, “You got shot!” and he would wake up!


One final note:  if you’d like to share with Flannery your responses to her efforts, please use the “comment” option on this blog or email me directly at and I’m happy to pass along to her.

Friday, September 11, 2015

9/11: A Writer Responds

I have a file labeled “Sept. 11 – Various.”  Within it are stacks of paper from major news sources, all related to the events of September 11, 2001.  

Among them are two articles from The New Yorker; an entire issue of Time magazine; and whole sections of the New York Times, including the front page from Wednesday, September 12, 2001, the headline screaming:


And of course there are a month’s worth of my journal notes, all attempting to describe my own experience of 9/11, starting with the day itself. 

Here’s a brief excerpt:

“And the city of Chicago has been virtually closed down: all major universities, Water Tower Place, the Field Museum, Art Institute, General Cinemas, Terra Museum, 900 N. Michigan, all federal, state, and city buildings, the state capitol in Springfield, shopping malls in the suburbs, the Borders & Barnes & Noble stores on Diversey, the Sears Tower was the first, the Hancock Center, Mercantile Exchange etc. etc.”

But among all these papers, what I found especially moving was an essay by the writer A.M. Homes.  It was from the Monday, September 24 edition of the New York Times, in a series the paper regularly ran called, “Writers on Writing.”  

Much had been made in the days and weeks following the attacks about how the arts and entertainment media could even begin to respond to the horror of what had happened on that beautiful fall day in Manhattan.  

Homes, as a writer, rises to that awful occasion in powerfully rendered—because so true and heartfelt—words and images.

Here's the essay in its entirety, "Seeing the Unimaginable Freezes the Imagination":

Tuesday, September 1, 2015

Boomers & Millennials: Kindred Spirits

Yesterday, a friend posted this link on my Facebook page—it’s to an article written by Anjulie Rao on the Chicago Architecture Foundation’s website. 

My friend knows of my determination to live out my golden years in Chicago, the city I’ve lived in for nearly 50 years, give or take a year each in Manhattan and Madison, Wisconsin, and those couple of crazy months in New Mexico.

I’ve copied the text of the article below (in Comic Sans), so I can comment directly on each of the five things Ms. Rao thinks we should know about Boomers and city living.  My comments appear in bold.

5 Things You Should Know About Baby Boomers and City Living
by Anjulie Rao

We’re excited to see how the lifestyles of this great generation will impact the way cities are designed. How might we see Chicago’s built environment evolve to adapt to the many Baby Boomers getting ready to retire?

The question posed in the second sentence has been on my mind for awhile, though it doesn’t seem to be on the minds of our current politicians or city administrators. 

But, despite their collective silence on the matter, the age wave being driven by the Boomers is gathering strength, including in cities, and so I’m happy that Ms. Rao has asked the question.


Political issues surrounding topics like Medicaid and social security are bringing a lot of attention to the Baby Boomers. Between 1946 and 1964, the US saw a major population increase in this generation, hovering around 76 million babies born.

Now that this population is approaching retirement, researchers and senior citizen advocates such as the American Association for Retired Persons (AARP) are launching initiatives to understand how the individuals who make up this important generation are preparing for the next stage of their lives.

Actually, Boomers may be approaching retirement, but a large segment, over half, are not retiring. (See #3 below).  In truth, we probably need to better distinguish between the traditional retirement age—65—and when we actually stop working.  In this regard, we know well that the times they are a-changin'.

And as for “preparing for the next stage of their lives,” I’m betting that a sizeable number of Boomers have not done so.  Certainly they, as well as those who study these things, were not prepared for this large number of human beings living so long and in such good health—a first in our species’ history.


What constitutes a livable environment? According to the AARP, “As the U.S. population ages, we face a serious challenge: our communities are not prepared for an aging society. In an effort to address this urgent problem, AARP sought to help consumers and policymakers decide whether their communities are places where residents can easily live as they get older. Taking a multifaceted approach to assessing livability at the neighborhood level, AARP developed this ground-breaking tool to jump-start community conversations about livability and encourage action by consumers and policymakers alike.”

Enter The Livability Index, a survey given to 4,500 individuals, ages 50 and above, to get a sense of general preferences for livability. The survey examined major elements of day-to-day living, including housing, health and transportation. The overarching trends indicate that seniors:

Tend to vary their social gathering spaces (private homes and public places)
Desire access to public transit
Value neighborhoods with good schools

So,what is a livable place as we age?  The answer, of course, will vary, but for me, it is still a decent-sized city with all three of those “trends” listed above.  Also lots of diversity in race, ethnicity, age, income level, cultural offerings, and a good blend of the built and natural environments.  

Encountering that mix is what accounts for much of my day-to-day pleasure while walking and biking the streets of Chicago, and while on buses and trains.  Engaging with people with vastly different stories reminds me of what it is about human beings that is essentially the same. It also broadens my horizons and my mind, and keeps me from getting too rigid in my thinking or set in my ways.

Then there is the multitude of ethic restaurants and markets selling falafel, enchiladas mole, and pad thai.  How could my golden years possibly glow without those just up the street or an “L” ride away?


Surveys have found that the Baby Boomer generation is preparing for the next stage of life in very different ways than generations prior. It was common for generations before the Baby Boomers to stay with a company for three or even four decades before retiring. Today though, many Boomers continue sharpening their professional skills, in large part because 65% of this generation foresees working past retirement age, or not looking towards retirement at all. Only 32% are counting on social security as their primary income source. Obviously, attitudes toward aging are changing.

It has been suggested that Baby Boomers are also looking to maintain active lifestyles. Support by recent survey data suggests that seniors are less interested in moving to retirement communities and more enticed by urban areas, whether staying in the city they live in, or moving to places where transit and amenities are more readily available.

Yes, despite all the adverts, more of us geezers are running in the other direction from living in a retirement community. Again, it has to do with diversity.  Even if I could afford it, which I can’t, I believe that in such an environment I would suffer irreparably from SSD (Severe Stimulation Deprivation).


The main goal of designing a livable area is improving health. The physical health of the city’s residents, creating positive and equitable community relations and ensuring that sustainability are all a priority. Housing and transportation remain key to creating and maintaining that environment.

Transit Oriented Development (TOD) refers to zoning laws that connect high-density housing and transportation. The Livability Index reveals that seniors desire access to affordable, sustainable public transit and also, a variety of housing options with access to said transit. Seniors, whether single or families, want to live in a diverse environment. Along with diversity in housing comes opportunities for greater numbers of affordable housing. In Chicago, laws mandate a specific percentage of units in a building to be designated as affordable, and greater numbers of rezoned TODs can potentially bring about more affordable housing for seniors and families.

And so to my greatest concern about being able to grow really old in the city: will I be able to afford it?  I may know more about that later this month, after attending an event sponsored by the Center for Neighborhood Technology: Transit-Oriented Development (TOD) and Community Change, which will address, among related issues, affordable housing in Chicago.

According to Peter Ellis, Principal at CannonDesign (designing future infrastructure for Boomers), we’re looking at a future in which Millennials and seniors will make up roughly half of the population of the average American city.

What is most striking about the findings of the Livability Index is how universal they are. Community amenities such as quality parks and maintained pedestrian areas, mixed-use living and access to sustainable transit, have typically been associated with younger generations who opt for bikes and public transportation over cars, and prefer local grocery stores and farmers markets to supermarket chains.

In actuality, the desires of Millennials and seniors seem to match. As more young people move into cities, demanding efficient and affordable living spaces, they may find that their closest allies for vibrant, sustainable communities are the Baby Boomers living next door.

Since learning about the Millennials, including that their numbers are about to overtake those of the Boomers*, I’ve felt a weird affinity for this age group (18 – 34), some of which has to do with certain shared values, including urban living and the transit options that come with it. (Seriously, anything to reduce the  number of cars clogging the streets, my view, my ears, and my lungs.) 

And so I will eagerly look forward to having those young’uns as allies in making our cities more humane, sustainable, equitable, and pedestrian-and bike-friendly.